By Pam Marshalla
Q: My 12-year-old client can produce an R, but he hesitates on either side of it. For example, he says, “I’m [slight pause] ready.” This pause is for a fraction of a second. Do you have any thoughts or suggestions? This is an example of one of the limitless number of ways clients can mess up a perfectly good R. Your client can produce R, therefore his problem is not with R at this point. His problem is in the…
By Pam Marshalla
Q: My client has an anterior open bite, a very strong thumbsucking habit, and a frontal lisp of S and Z. My first impression is to wait to work on speech until after the teeth are firmly in place and the sucking habit is eliminated. Do you agree with this? Yes. In regard to the teeth, it is my opinion that it does no good to work on the sibilants until the “anterior dental barrier” (consisting of the front teeth)…
By Pam Marshalla
Q: How do you teach an R? I just don’t get it! Some kids get it right away and other cannot seem to bunch up the back of their tongues no matter what I do. It sounds like you are always teaching what I call a “Back R.” Teaching a Back R is much more than teaching the client to bunch up the back of the tongue. The “Back R” position is attained by spreading, elevating, and retracting the back…
By Pam Marshalla
Q: Can I work on R with my client who has a palatal expander? My experience has taught me the following: Typical braces, palatal expanders, and the like should not interfere much with the sound quality of R and we can go ahead and begin treatment. However… Oral appliances can interfere with our work on R and other phonemes if there is oral pain in association with them. Wait a few weeks until the pain subsides or is managed appropriately….
By Pam Marshalla
Q: Do you believe that early frequent use of sippy cups can contribute to, establish, or perpetuate a frontal lisp in children? I find it hard to believe that a sippy cup would cause a frontal lisp pattern in an otherwise normal child. I suspect it can happen, but we don’t have real evidence for this. These are the types of questions that I wish young doctoral students would begin to focus on in their research. We need answers to…
By Pam Marshalla
Q: My beautiful nearly four-year-old son was diagnosed with verbal apraxia around the age of two. There does not seem to be any other developmental issues of concern. Have you found that an alternative schooling program is better for the preschool aged children with apraxia? If so what type of schooling would you suggest? He currently is enrolled in the public school system and only receives one half-hour of speech therapy three days per week there. We also go to…
By Pam Marshalla
Q: It seems that every SLP has a different opinion on phoneme development and the age at which sounds should be treated. For example, some SLP’s work on R at age 6 while others wait until clients are age 7 or 8. What is your opinion on sound development? I have been re-studying the developmental articulation norms for the past two years in preparation for my next book, and I have to admit the data is all over the place….
By Pam Marshalla
Q: I have heard that we should avoid the topic of tongue-thrust therapy (orofacial myofunctional therapy). I’d like to hear your thoughts on this. In my experience, problems in articulation, orofacial myology, feeding, dysphagia, and motor speech disorders are all the same thing manifested in somewhat different ways and to various degrees. All of these therapies are about facilitating new oral movements and/or fixing incorrect oral movements. I have spent my entire career (since 1975) studying the research, clinical practices,…
By Pam Marshalla
Q: I am using your “Long T Method” to establish an S sound. Now the student cannot get rid of it. For example, she pronounces “juice” as “juits.” Please help! The Long T Method from Frontal Lisp, Lateral Lisp is a process of using T to establish correct tongue position for S. One uses T, and then “blows more air” to make an aspirated T, or Long T, as a substitute for S at the ends of words. Words like…
By Pam Marshalla
Q: I am considering whether or not to purchase your book, How to Stop Drooling. I wondered if it would be appropriate for my 5th grade student? The book is appropriate for any person who drools to excess. Whether or not the ideas will help your specific student is unknown. The book contains practical ideas to consider for any type of client. Two other resources to consider: Rosenfeld-Johnson, S. (2005b) Drooling Remediation Program for Children and Adults. Tucson: Talk Tools. Johnson,…
